TY - JOUR
T1 - Majority of new onset of dental caries occurred from caries-free students
T2 - A longitudinal study in primary school students
AU - Kusama, Taro
AU - Todoriki, Hidemi
AU - Osaka, Ken
AU - Aida, Jun
N1 - Funding Information:
Funding: This work was supported by a grant-in-aid for scientific research (Grant Number: 25282023) from the Japan Society for the Promotion of Science.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/11/2
Y1 - 2020/11/2
N2 - We examined Rose’s axiom that a large number of people exposed to a small risk may generate more cases than a small number exposed to a high risk, using data on caries incidence. This longitudinal study was based on the records of annual dental checks conducted in primary schools in Okinawa, Japan. Participants were students aged 6–11 years at baseline in 2014, and a follow-up survey was conducted after one-year. The outcome variable was the increased number of decayed, missing, and filled teeth (DMFT). The predictor variable was the baseline DMFT score. Gender, grade, and affiliated school variables were adjusted. A negative binomial regression model was used to obtain the estimated increase of DMFT score. Among 1542 students, 1138 (73.8%) were caries-free at baseline. A total of 317 (20.6%) developed new caries during the follow-up. The predicted number of new carious teeth in a caries-free students and students with DMFT = 1 at baseline were 0.26 (95% CI, 0.22–0.31) and 0.45 teeth (95% CI, 0.33–0.56), respectively. However, among the total of 502 newly onset of carious teeth, 300 teeth (59.7%) occurred from the caries-free students at baseline. Hence, prevention strategies should target the low-risk group because they comprise the majority of the population.
AB - We examined Rose’s axiom that a large number of people exposed to a small risk may generate more cases than a small number exposed to a high risk, using data on caries incidence. This longitudinal study was based on the records of annual dental checks conducted in primary schools in Okinawa, Japan. Participants were students aged 6–11 years at baseline in 2014, and a follow-up survey was conducted after one-year. The outcome variable was the increased number of decayed, missing, and filled teeth (DMFT). The predictor variable was the baseline DMFT score. Gender, grade, and affiliated school variables were adjusted. A negative binomial regression model was used to obtain the estimated increase of DMFT score. Among 1542 students, 1138 (73.8%) were caries-free at baseline. A total of 317 (20.6%) developed new caries during the follow-up. The predicted number of new carious teeth in a caries-free students and students with DMFT = 1 at baseline were 0.26 (95% CI, 0.22–0.31) and 0.45 teeth (95% CI, 0.33–0.56), respectively. However, among the total of 502 newly onset of carious teeth, 300 teeth (59.7%) occurred from the caries-free students at baseline. Hence, prevention strategies should target the low-risk group because they comprise the majority of the population.
KW - Dental caries
KW - Longitudinal study
KW - Population approach
KW - Prevention paradox
KW - Universal health coverage
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U2 - 10.3390/ijerph17228476
DO - 10.3390/ijerph17228476
M3 - Article
C2 - 33207679
AN - SCOPUS:85096093635
SN - 1661-7827
VL - 17
SP - 1
EP - 9
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 22
M1 - 8476
ER -
